title: Home food environment, dietary intake, and weight among overweight and obese children in Southern Appalachia.
abstract: OBJECTIVE
  This study examined the relation of multiple aspects of the home food environment to dietary intake and body weight among overweight and obese children in southern Appalachia.
  
  
  METHODS
  The study used baseline data from a cluster-randomized controlled trial, Parent-Led Activity and Nutrition for Healthy Living, evaluating a parent-mediated approach to treating child overweight and obesity in the primary care setting in southern Appalachia. Sixty-seven children ages 5 to 11 years were recruited from four primary care clinics. Multiple linear regression was used to estimate the relation between multiple aspects of the home food environment to dietary intake (fruit and vegetable intake, fat and sweets intake), and standardized body mass index (zBMI), adjusted for baseline family characteristics (education, smoking status during the past month, BMI) and child characteristics (sex, age, Medicaid/TennCare).
  
  
  RESULTS
  Findings showed greater parental restriction and pressure in feeding were associated with greater fruit and vegetable intake in children (β = 0.33, β = 0.30, respectively; both P < 0.05). The availability of chips and sweets in a child's home and parental inappropriate modeling of eating were associated with an increased risk for consumption of fats and sweets by children (β = 0.47, β = 0.54, respectively; both P < 0.01). Parental monitoring of the child's eating was associated with a reduced risk for fat and sweets intake (β = -0.24; P < 0.01). Finally, parental responsibility for feeding the child was associated with lower zBMI (β = -0.20; P < 0.05).
  
  
  CONCLUSIONS
  The home food environment, including food availability and parenting behaviors, was associated with overweight and obese children's dietary intake and weight. This study adds to evidence suggesting that programs aimed at improving overweight and obese children's eating patterns may target both aspects of the physical home environment and parental behaviors surrounding eating.
authors.affiliation: From the Departments of Biostatistics and Epidemiology, Psychology, Pediatrics, and Family Medicine, James H. Quillen College of Medicine, East Tennessee State University, Johnson City.
authors.forename: Liang
authors.initials: L
authors.lastname: Wang
authors.forename: William T
authors.initials: WT
authors.lastname: Dalton
authors.forename: Karen E
authors.initials: KE
authors.lastname: Schetzina
authors.forename: Hazel
authors.initials: H
authors.lastname: Fulton-Robinson
authors.forename: Nicole
authors.initials: N
authors.lastname: Holt
authors.forename: Ai-leng
authors.initials: AL
authors.lastname: Ho
authors.forename: Fred
authors.initials: F
authors.lastname: Tudiver
authors.forename: Tiejian
authors.initials: T
authors.lastname: Wu
mesh_terms: D000328:Adult; D001061:Appalachian Region; D001294:Attitude to Health; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004032:Diet; D004034:Diet Surveys; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008425:Maternal Behavior; D009765:Obesity / Q000209:etiology; D050177:Overweight / Q000209:etiology*; D010287:Parent-Child Relations; D016487:Parenting; D010332:Paternal Behavior; D057566:Self Report; D012959:Socioeconomic Factors